PB2473: OBSERVATION AND NURSING OF PATIENTS COMPLICATED WITH I-II HEMORRHAGIC CYSTITIS AFTER ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION WITH STANDARDIZED HYDRATION SCHEME
Authors: Xinrong Yu, Xiaoli Chen, LI Wang, Quanxi Tang
Journal: HemaSphere (2023)

Topic: 22. Stem cell transplantation - Clinical Background: At present, patients with hemorrhagic cystitis are prone to complications such as hemorrhagic cystitis when undergoing allogeneic hematopoietic stem cell transplantation or after transplantation. Patients with hemorrhagic cystitis are clinically characterized by bladder irritation signs such as hematuria, painful urination, frequent urination and urgency of urination. At present, there is no effective drug treatment, and prevention is the main clinical treatment. Therefore, this study mainly analyzes the nursing effect of targeted standardized hydration scheme in patients with I-II hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation. Aims: To summarize the nursing observation effect of targeted standardized hydration scheme in patients with hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation. Methods: 52 patients with I-II hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation in our hospital from January 2020 to December 2022 were studied. All 52 patients had frequent urination, urgency, pain in urination, and bladder irritation symptoms. Among them, 24 patients had gross hematuria, 11 patients had blood filaments and a small amount of blood clots, and 5 patients had continuous bladder irrigation with physiological sodium chloride solution. According to the digital pain score, 43 patients had mild pain, 6 patients had moderate pain, and 3 patients had severe pain. All patients were issued with self-made statistical and quantitative forms to teach patients and their families to record hydration intake and output statistics and self-pain assessment, observe the color and characteristics of urine, and make records, and implement personalized and targeted standardized hydration programs according to the patient’s input and output statistics and the patient’s pain assessment score. Inform the patient that the daily intake of water content is more than 2500-3500ml, the urine volume is more than 5000-6000ml, and the amount of drinking water at night is at least 1000ml. For those with poor appetite and difficulty in drinking water, appropriate amount of rehydration should be added, and alkalized urine, anti-virus, mesenchyme, intravenous immunoglobulin, spasmolysis and pain relief should be given at the same time. For patients with frequent nocturnal urination and poor sleep, adjust the time of rehydration, reduce the amount of rehydration during the day, drink as much water as possible, continue to infuse 1500-2000 ml of liquid at a constant rate at night, and strengthen the sterilization of urethral orifice after urination to avoid infection. Results: After 3 weeks of individualized and targeted hydration treatment, the symptoms of gross hematuria, frequency of urination, urgency of urination, pain of urination and bladder irritation disappeared in all patients, and the urine routine returned to normal without any complications. Summary/Conclusion: Nurses should master the key points of monitoring and observation of hemorrhagic cystitis, teach patients and family members to detect themselves, inform doctors and nurses immediately if they feel uncomfortable, and actively cooperate with effective treatment and nursing measures, which can improve the cure rate of hemorrhagic cystitis, effectively alleviate the pain of patients, improve the quality of sleep, save the hospitalization expenses of patients, and improve nursing satisfaction. Keywords: Allogeneic hematopoietic stem cell transplant